ADHD and Motor Tics in Children

A motor tic is generally defined as a brief, sudden movement or sound that increases with excitement, stress or anxiety. It occurs most commonly in children and teenagers and usually is transient. The movements or vocal sounds may change. Examples are blinking eyes, nose twitches, clearing of the throat, short squeals. The children who most commonly exhibit motor or vocal tics also have the condition of ADHD or OCD (obsessive compulsive disorder). Tics can be very annoying, but are not life threatening and often will wax or wane depending on the life situation. I often tell parents that it can be a helpful indicator of the stress level their child is experiencing. Evaluation of the stressors and doing something about them can be invaluable.

Many times, the onset of motor or vocal tics occur about the same time that the symptoms of ADHD also occur. When a child is put on medication for the ADHD, parents might notice tic onset. It might be coincidental that they both began at the same time, but some of the medications used to treat ADHD might make the tics worse. When that happens, I often advise parents to hang in there and minimize the attention given to the tics, particularly if the ADHD symptoms have improved by the medication.

Some parents ask about whether their child has Tourette syndrome. Tourette syndrome is a developmental neurological disorder that has persistent motor and vocal tics that is frequently associated with obsessions and compulsions and attention difficulties. It is a hereditary disorder that is strongly influenced by environmental factors. To meet the criteria for Tourette syndrome, there must be 1) multiple motor tics 2) one or more vocal tic 3) onset before age 18 years 4) duration greater than one year and 5) disturbances that cause distress and impairment.

Tourette syndrome usually starts when a child is five-years-old, which is also the age that ADHD may present. When the child is put on medication for ADHD, motor tics may occur, and it can be confusing as to what is happening. New research has shown that the Tourette child who has started on ADHD medication actually may have improvement of the tics, unless the child is in a crisis situation.

Don’t be afraid to discuss the condition with your physician. Motor tics can be very concerning, but hopefully will be transient and therefore manageable.

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ABOUT THE AUTHOR

Donna Krutka, MD

Dr. Krutka is a board-certified pediatrician who works in private practice in Tulsa, Oklahoma. Her practice includes all ages of patients from newborns to young adults. Her areas of interest include attention...read more